Evaluation of post-implant buccal bone resorption using cone beam computed tomography: a clinical pilot study

Buccal bone responses following dental implant placement are considered significant determinants of esthetic outcomes. The aim of this pilot study was to evaluate whether cone beam computed tomography (CBCT) could be used to measure buccal alveolar bone changes following implant placement. The second aim of this investigation was to determine both qualitatively and quantitatively if changes could be determined 1 year postoperatively at the buccal aspect of implants placed in healed ridges or extraction sockets.

Twenty patients in need of a single tooth in the maxillary anterior or first premolar region were recruited under an institutional review board-approved protocol. Patients were allocated into two groups: those missing a tooth with a healed alveolar ridge and those needing an extraction. Following treatment planning, implants were placed and immediately loaded. Zirconia abutments and all-ceramic crowns were delivered 16 weeks following implant placement. CBCT images of the maxilla were obtained at three different time points; 2 weeks before surgery, immediately after surgery, and 12 months after implant placement. A single examiner measured each implant three times in four different sites. The data between different implants or subjects were compared among groups by the nonparametric sign test.

Evaluation of the CBCT images revealed that it was possible to discern the presence or absence of the buccal bone plate both prior to and 1 year following implant placement in the majority of subjects. The median alteration after 1 year for the vertical distance from the abutment/implant interface to the buccal alveolar bone crest for all subjects was -1.12 mm (P = .018). The horizontal alteration of the buccal bone measured 1 mm apical to the implant/abutment interface was -0.62 mm (P = .004). At the midimplant and apical regions of the implants, the 1-year horizontal bone alteration was -0.57 mm (0.004) and -0.19 mm (P = .059), respectively.

Buccal bone and alterations following implant placement may be visualized by CBCT in both extraction sockets and healed ridges. When the implant was appropriately displaced from the buccal wall of the socket, bone changes could be qualitatively evaluated by CBCT 1 year following placement.